This invention relates to a surgical plug and a method of plugging a puncture wound with a surgical plug during surgery. More particularly, it relates to a plug adapted for minimizing leakage of insufflation fluids within an internal bodily cavity during an endoscopic procedure, and the method of using a surgical plug to prevent leakage during these procedures.
During an endoscopic surgical procedure, a pressurizing fluid such as carbon dioxide gas is pumped into the body cavity to separate organs from one another so that the surgeon has room to maneuver surgical instruments within the surgical site during the procedure. When the body cavity is pumped with the inflation fluid, the "insufflated" body cavity must be maintained in this condition during the procedure. Therefore, puncture wounds made to provide a passageway into the body cavity must be scaled against leakage of the insufflation fluid from the body cavity through the puncture. Additionally, surgical instruments inserted through the puncture into the body cavity must also be sealed to prevent leakage of the insufflation fluid from the body cavity through the instrument. Therefore, the instruments which provide a passageway into the body cavity and instruments which can manipulate body tissue to perform an operative procedure have sealing mechanisms to prevent leakage and therefore maintain the body cavity in the insufflated state. These instruments include trocar assemblies which incorporate a flapper valve within a tubular passageway referred to as a trocar "cannula", and endoscopic clip appliers and staplers, which have different sealing mechanisms to obstruct the flow of insufflation fluid through the instrument.
Although endoscopic surgical instruments incorporate seals to maintain insufflation, it sometimes becomes necessary to remove these instruments during surgery and expose an open puncture wound where insufflation fluids can freely escape from the body cavity. For example, a surgeon may inadvertently place a trocar cannula in the wrong position. Although the trocar cannula seals the puncture wound, the surgeon may want to remove the inadvertently placed trocar cannula and reposition the cannula at another location. When the cannula is removed, the puncture wound with the opening it defines will not be sealed. Additionally, it may be desirable to carry out certain procedures without using trocar cannulas to seal the passageway into the body while various instruments are inserted and withdrawn. In these instances, when an instrument is withdrawn from the body cavity, the puncture opening is exposed and insufflation fluids can leak from the body cavity through the opening.
It is therefore desirable to provide a simple sealing device to maintain insufflation during an endoscopic procedure which can easily and effectively seal a puncture opening which has provided access to a surgical site within a patient's bodily cavity. It would also be desirable if a surgical method were developed to maintain an insufflated body cavity during a surgical procedure when a puncture opening providing access to the surgical site within the body cavity needs to be sealed in a straightforward and effective manner to maintain the insufflation. Furthermore, it would be beneficial if such a surgical sealing device and method could be developed which can provide these objectives without sacrificing the field of vision at the surgical site during the endoscopic surgical procedure. Finally, it would be especially desirable if such a device and surgical method could accomplish all of these objectives and yet also provide a device which is stable so that the surgeon can be assured of an effective seal during the entire procedure.